Involuntary Psychiatric Holds: California Law

California Legal Codes empower police officers and other medical health professionals to detain individuals involuntarily for 72 hours if the patient is suspected of suffering from a mental disorder. The California Welfare & Institutions Code refers to this as a “5150”. Consumers can only be involuntarily detained if they meet the following criteria:

• The patient is a danger to themselves (i.e., expresses suicidal ideation with a plan).
• The patient is a danger to others (i.e., explicitly express homicidal ideation or has threatened specific individuals, and has articulated a plan to carry out the threat).
• Patients are assessed to be “gravely disabled” (i.e., are unable to independently take care of their basic needs for food, basic hygiene, clothing and shelter).

Legal Rights of Patients who are Involuntarily Held in a Psychiatric Facility

• Once residents are involuntarily held and ordered to be transferred to a psychiatric facility, they must be informed by medical staff or a police officer why they are being held.
• Within the 72-hour hold, a multidisciplinary team of psychiatrists, social workers, police officers (if hold was ordered by one), and other relevant medical staff must conduct a thorough evaluation and mental status exam. If resident is not evaluated, they legally cannot be held.

Consumer Legal Rights

Involuntary patients have the right to accept or refuse the administration of psychotropic medications.
If the patient does consent to taking psychotropic medications, the doctor must provide, a list of all potential side effects.
A resident can refuse to take medications. However, the resident can later be forced to take the medicine if after a probable cause hearing, it is determined that the patient lacks the ability to make medical decisions.

Who Can Determine Involuntary 72-hour Psychiatric Holds (Welfare & Institutions Code 5150)?

• Medically licensed professionals can call 5150s. This includes: doctors, nurses, psychiatrists, psychologists, licensed marriage and family therapists (LMFT), and licensed clinical social workers (LCSW).
• Police officers are the only other professional that can call 5150s.
• PMRT (psychiatric mobile response teams) are multidisciplinary team composed of at least one medically licensed professional. Social workers can also call 5150s.
• SMART (system-wide mental assessment response team) is similar to PMRT, except that a police officer is always on the team. These teams can also call 5150s.

Helpful Questions to Ask if Involuntarily Held

• Is this an involuntary psychiatric hold or a doctor ordered medical transfer?
• If this is a medical transfer, the resident has the right to refuse treatment and can refuse to be transferred.
• If residents are being “5150ed”, they should ask why, as they have a legal right to be informed of the reason.
• If residents are prescribed psychotropic medications, they should ask for a list of side effects.
• If residents have not been psychiatrically evaluated by a clinical staff member, they must be within the 72-hour hold period.

Contacts

LA County Dept. of Mental Health Patient Rights: (213)-738-4888
Disability Rights Advocates: (213)-738-4888
Long-Term Care Ombudsman Program: (800) 334-WISE (9473)